1. © 2011 Blue Cross and Blue Shield of Minnesota. All rights reserved. Tailoring efforts to reach LGBT communities: Minnesota’s tobacco quitline case study Sarah Senseman, MPH Kim Milbrath, MPH October, 2011

2. 2 OVERVIEW History / Context LGBT Data Collection Cultural Competency Tailored material development Tailored media Lessons learned / Impact

3. History and Context

4. 4 The Minnesota Context Multiple quitline providers Lack of LGBT data Large LGBT community High smoking prevalence

5. STEP ONE Assessing LGBT

6. 6 How do we collect the data? Identify best practice question Cognitive testing research Several communities have been targeted by the tobacco industry or have higher smoking rates. We have some special materials for people in these communities. So we’d like to ask you some demographic questions, please remember your answers are completely confidential. Do you consider yourself to be one or more of the following: [say the letter so that they can respond by letter] a) Straight b) Gay or Lesbian c) Bisexual d) Transgender [IF pause or refusal/none of above, also say: You can name a different category if that fits you better: _____________________

7. STEP TWO Training Quitlines

8. 8 Training Quitlines How to ask the LGBT question How to provide tailored counseling to LGBTs -LGBT and Tobacco Orientation -LGBT Quitline Strategies Link to modified training on GLMA website: http://www.glma.org/index.cfm?fuseaction=Page.viewPage&pageId=92 5&grandparentID=534&parentID=924&nodeID=1

9. STEP THREE Developing tailored materials

10. 10 Materials Development Did not want to duplicate / modify evidence-based tools Address cultural aspects NOT covered in general materials Create a feedback loop for accountability

11. 11 The Quit Guide Used Consumer Advisory Board to develop Featured local LGBT community guides Quotes / testimonials from LGBT community members Addressed culturally-specific issues Links to local resources beyond quitline Feedback loop to National Network www.lgbttobacco.org

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14. STEP FOUR Tailoring Media

15. 15 Media Tailoring / Promotion Focus Groups Consumer Advisory Board Learnings: - Lack of familiarity with quitline - Positive messages preferred - “support” theme - needs to identify as LGBT-safe - Web as intermediate step in access - Diverse ad placements – not LGBT-specific only

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20. Lessons Learned / Impact

21. 21 LESSONS LEARNED - Partnerships are key! Key partners: - Internal Blue Cross advocates - Blue Cross leadership - Call It Quits Collaborative - Statewide LGBT Health Network - Consumer Advisory Board -Evaluation is Challenging but necessary -Impacts can be broad with the right networking

22. 22 Evaluation Methods Quality control of data collection Quitline call volume versus prevalence Evaluation of cultural competency trainings Promotional campaign and impact on call volume Follow-up interviews with participants Feedback from community partner organizations

23. 23 Impacts Positive Community Response Cognitive Testing of LGBT Question article GLMA adoption of cultural competency training Use of quitguide in other states Congressional briefing / National Coalition for LGBT Health LGBT question added to Adult Tobacco Survey and Physical Activity survey in Minnesota State programs received consultation on our process

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